Orthodontic bone screws: A comprehensive review of applications and clinical outcomes and role of pharmacists
Keywords:
orthodontic bone screws, TADs, extra-alveolar anchorage, orthodontics, pharmacist role, peri-implant careAbstract
Background: Temporary Anchorage Devices (TADs), such as orthodontic bone screws, have revolutionized anchorage management in orthodontics. Since their introduction in 1997, TADs have been widely adopted to improve treatment outcomes, especially in complex malocclusions. Despite their efficacy, challenges such as high failure rates in inter-radicular (I-R) placement and limited clinical integration persist. Aim: This comprehensive review explores the clinical applications, outcomes, and barriers to adopting orthodontic bone screws, with a focus on extra-alveolar (E-A) TADs. Additionally, the role of pharmacists in optimizing patient care in orthodontic treatments involving TADs is examined. Methods: The review analyzes studies on TAD applications, clinical outcomes, and failure rates, emphasizing extra-alveolar sites such as the mandibular buccal shelf (MBS) and infra-zygomatic crest (IZC). It also discusses pharmacist contributions in medication management, patient education, and minimizing peri-implant inflammation. Results: E-A TADs demonstrated lower failure rates (7%) compared to I-R TADs (19.3%), with superior stability in IZC and MBS placements due to enhanced cortical bone contact. Pharmacists play a critical role in managing peri-implant inflammation, advising on hygiene practices, and providing medications that mitigate infection risks. Conclusion: TADs offer a reliable anchorage solution for complex malocclusions, with E-A placements yielding better outcomes.
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References
Roberts WE, Helm FR, Marshall KJ, Gongloff RK. Rigid endosseous implants for orthodontic and orthopedic anchorage. Angle Orthod. 1989; 59(4): 247-256.
Feldmann I, Bondemark L. Orthodontic anchorage: a systematic review. Angle Orthod. 2006; 76(3): 493-501.
Lee K-J, Park Y-C, Hwang C-J, et al. Displacement pattern of the maxillary arch depending on miniscrew position in sliding mechanics. Am J Orthod Dentofacial Orthop. 2011; 140(2): 224-232. DOI: https://doi.org/10.1016/j.ajodo.2010.05.020
Kanomi R. Mini-implant for orthodontic anchorage. J Clin Orthod. 1997; 31(11): 763-767.
Labanauskaite B, Jankauskas G, Vasiliauskas A, Haffar N. Implants for orthodontic anchorage. Meta-analysis. Stomatologija. 2005; 7: 128-132.
Chen Y, Kyung HM, Zhao WT, Yu WJ. Critical factors for the success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofacial Orthop. 2009; 135: 284-291. DOI: https://doi.org/10.1016/j.ajodo.2007.08.017
Reynders R, Ronchi L, Bipat S. Mini-implants in orthodontics: a systematic review of the literature. Am J Orthod Dentofacial Orthop. 2009; 135(5): 564.e1-564.e19. DOI: https://doi.org/10.1016/j.ajodo.2008.09.026
Papadopoulos M, Papageorgiou S, Zogakis I. Clinical effectiveness of orthodontic miniscrew implants: a meta-analysis. J Dental Res. 2011; 90(8): 969-976. DOI: https://doi.org/10.1177/0022034511409236
Tsui WK, Chua HDP, Cheung LK. Bone anchor systems for orthodontic application: a systematic review. Int J Oral Maxillofac Surg. 2012; 41(11): 1427-1438. DOI: https://doi.org/10.1016/j.ijom.2012.05.011
Jambi S, Walsh T, Sandler J, et al. Reinforcement of anchorage during orthodontic brace treatment with implants or other surgical methods. Cochrane Database Syst Rev. 2014( 8): CD005098. DOI: https://doi.org/10.1002/14651858.CD005098.pub3
Antoszewska-Smith J, Sarul M, Łyczek J, Konopka T, Kawala B. Effectiveness of orthodontic miniscrew implants in anchorage reinforcement during en-masse retraction: a systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2017; 151(3): 440-455. DOI: https://doi.org/10.1016/j.ajodo.2016.08.029
Schätzle M, Männchen R, Zwahlen M, Lang NP. Survival and failure rates of orthodontic temporary anchorage devices: a systematic review. Clin Oral Implants Res. 2009; 20(12): 1351-1359. DOI: https://doi.org/10.1111/j.1600-0501.2009.01754.x
Papageorgiou SN, Zogakis IP, Papadopoulos MA. Failure rates and associated risk factors of orthodontic miniscrew implants: a meta-analysis. Am J Orthod Dentofacial Orthop. 2012; 142(5): 577-595. DOI: https://doi.org/10.1016/j.ajodo.2012.05.016
Dalessandri D, Salgarello S, Dalessandri M, et al. Determinants for success rates of temporary anchorage devices in orthodontics: a meta-analysis (n>50). Eur J Orthod. 2013; 36(3): 303-313. DOI: https://doi.org/10.1093/ejo/cjt049
Keim RG, Gottlieb EL, Vogels D III, Vogels PB. 2014 JCO study of orthodontic diagnosis and treatment procedures, part 1: results and trends. J Clin Orthod. 2014; 48(10): 607-630.
Liou EJW, Pai BCJ, Lin JCY. Do miniscrews remain stationary under orthodontic forces? Am J Orthod Dentofacial Orthop. 2004; 126(1): 42-47. DOI: https://doi.org/10.1016/j.ajodo.2003.06.018
Hembree M, Buschang PH, Carrillo R, Spears R, Rossouw PE. Effects of intentional damage of the roots and surrounding structures with miniscrew implants. Am J Orthod Dentofacial Orthop. 2009; 135(3): 280.e1-280.e9. DOI: https://doi.org/10.1016/j.ajodo.2008.06.022
Alves M, Baratieri C, Mattos CT, de Souza Araujo MT, Maia LC. Root repair after contact with mini-implants: systematic review of the literature. Eur J Orthod. 2013; 35(4): 491-499. DOI: https://doi.org/10.1093/ejo/cjs025
Motoyoshi M, Uchida Y, Matsuoka M, et al. Assessment of damping capacity as an index of root proximity in self-drilling orthodontic mini-implants. Clin Oral Invest. 2014; 18: 321-326. DOI: https://doi.org/10.1007/s00784-013-0965-8
Chang CH, Lin JS, Yeh HY. Extra-alveolar bone screws for conservative correction of severe malocclusion without extractions or orthognathic surgery. Curr Osteoporos Rep. 2018; 16: 387-394. DOI: https://doi.org/10.1007/s11914-018-0465-5
Chang CH, Lin JS, Yeh HY, Roberts WE. Insights to extraradicular bone screw applications for challenging malocclusions. In: JH Park, ed. Temporary Anchorage Devices in Clinical Orthodontics. New Jersey, USA: John Wiley & Sons; 2020: 433-444. DOI: https://doi.org/10.1002/9781119513636.ch42
Straus SE, Tetroe J, Graham ID. Knowledge to action - what it is and what it isn’t. In: SE Straus, J Tetroe, ID Graham, eds. Knowledge Translation in Health Care: Moving from
Grimshaw JM, Eccles MP, Lavis JN, Hill SJ, Squires JE. Knowledge translation of research findings. Implement Sci. 2012; 7(1): 50-66. DOI: https://doi.org/10.1186/1748-5908-7-50
Leo M, Cerroni L, Pasquantonio G, Condò S, Condò R. Temporary anchorage devices (TADs) in orthodontics: review of the factors that influence the clinical success rate of the mini-implants. Clin Ter. 2016; 167(3): e70-e77.
Reynders RM, Ronchi L, Ladu L, et al. Barriers and facilitators to the implementation of orthodontic mini implants in clinical practice: a systematic review. Syst Rev. 2016; 5(1): 163-183. DOI: https://doi.org/10.1186/s13643-016-0359-5
Meeran NA, Venkatesh K, Parveen MJ. Current trends in miniscrew utilization among Indian orthodontists. J Orthod Sci. 2012; 1(2): 46-50. DOI: https://doi.org/10.4103/2278-0203.99762
Zawawi K. Acceptance of orthodontic miniscrews as temporary anchorage devices. Patient Preference and Adherence. 2014; 8: 933-937. DOI: https://doi.org/10.2147/PPA.S66133
Bock NC, Ruf S. Skeletal anchorage for everybody? A questionnaire study on frequency of use and clinical indications in daily practice. J Orofacial Orthop. 2015; 76: 113-128. DOI: https://doi.org/10.1007/s00056-014-0275-z
Nguyen T, Proffit WR. The decision-making process in orthodontics. In: LW Graber, RL Vanarasdall, KW Vig, GJ Huang, eds. Orthodontics: Current Principles and Techniques, 6th edn. St. Louis: Mosby; 2017: 208-244.
Georgalis K, Woods MG. A study of Class III treatment: orthodontic camouflage vs orthognathic surgery. Aus Orthod J. 2015; 31(2): 138-148. DOI: https://doi.org/10.21307/aoj-2020-148
Tseng L, Chang CH, Roberts WE. Diagnosis and conservative treatment of skeletal Class III malocclusion with anterior crossbite and asymmetric maxillary crowding. Am J Orthod Dentofacial Orthop. 2016; 149(4): 555-566. DOI: https://doi.org/10.1016/j.ajodo.2015.04.042
Roberts WE, Viecilli RF, Chang CH, Katona TR, Paydar NH. Biology of biomechanics: Finite element analysis of a statically determinate system to rotate the occlusal plane for correction of a skeletal Class III open-bite malocclusion. Am J Orthod Dentofacial Orthop. 2015; 148(6): 943-955. DOI: https://doi.org/10.1016/j.ajodo.2015.10.002
Grover PS, Lorton L. The incidence of unerupted permanent teeth and related clinical cases. Oral Surg, Oral Med, Oral Patho. 1985; 599(4): 420-425. DOI: https://doi.org/10.1016/0030-4220(85)90070-2
Laganà G, Venza N, Borzabadi-Farahani A, Fabi F, Danesi C, Cozza P. Dental anomalies: prevalence and associations between them in a large sample of non-orthodontic subjects, a cross-sectional study. BMC Oral Health. 2017; 17: 62-68. DOI: https://doi.org/10.1186/s12903-017-0352-y
Becker A, Chaushu S. Etiology of maxillary canine impaction: a review. Am J Orthod Dentofacial Orthop. 2015; 148(4): 557-567. DOI: https://doi.org/10.1016/j.ajodo.2015.06.013
Kokich V, Mathews D. Surgical and orthodontic management of impacted teeth. Dent Clini North Am. 1993; 37(2): 181-204. DOI: https://doi.org/10.1016/S0011-8532(22)00276-2
Kokich VG. Surgical and orthodontic management of impacted maxillary canines. Am J Orthod Dentofacial Orthop. 2004; 126(3): 278-283. DOI: https://doi.org/10.1016/j.ajodo.2004.06.009
Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review. Prog Orthod. 2018; 19: 37-60. DOI: https://doi.org/10.1186/s40510-018-0235-z
Galan-Lopez L, Barcia-Gonzalez J, Plasencia E. A systematic review of the accuracy and efficiency of dental movements with Invisalign®. Korean J Orthod. 2019; 49(3): 140-149. DOI: https://doi.org/10.4041/kjod.2019.49.3.140
Chugh VK, Sharma VP, Tandon P, Singh GP. Brodie bite with an extracted mandibular first molar in a young adult: a case report. Am J Orthod Dentofacial Orthop. 2010; 137(5): 694-700. DOI: https://doi.org/10.1016/j.ajodo.2008.04.033
Jung M-H. Treatment of severe scissor bite in a middle-aged adult patient with orthodontic mini-implants. Am J Orthod Dentofacial Orthop. 2011; 139(4): S154-S165. DOI: https://doi.org/10.1016/j.ajodo.2009.06.031
Suda N, Tominaga N, Niinaka Y, Amagasa T, Moriyama K. Orthognathic treatment for a patient with facial asymmetry associated with unilateral scissors-bite and a collapsed mandibular arch. Am J Orthod Dentofacial Orthop. 2012; 141(1): 94-104. DOI: https://doi.org/10.1016/j.ajodo.2010.02.042
Lee S-A, Chang CH, Roberts WE. Severe unilateral scissors-bite with a constricted mandibular arch: Bite turbos and extra-alveolar bone screws in the infrazygomatic crests and mandibular buccal shelf. Am J Orthod Dentofacial Orthop. 2018; 154(4): 554-569. DOI: https://doi.org/10.1016/j.ajodo.2017.03.032
Dai F-F, Xu T-M, Shu G. Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign. Angle Orthod. 2019; 89(5): 679-687. DOI: https://doi.org/10.2319/090418-646.1
Align Technology. Invisalign G6. http://www.invisalign-g6.com/en-XA.
Lin LY, Chang CH, Roberts WE. Mechanics and clinical significance for mini-screws in four bicuspid extraction aligner cases. J Digital Orthod. 2020; 58: 94-98.
Lin LY, Chang CH, Roberts WE. Bimaxillary protrusion with gummy smile treated with clear aligners: closing premolar extraction spaces with bone screw anchorage. APOS Trends Orthod. 2020; 10(2): 120-131. DOI: https://doi.org/10.25259/APOS_45_2020
Chang CH, Liu SSY, Roberts WE. Primary failure rate for 1680 extra-alveolar mandibular buccal shelf mini-screws placed in movable mucosa or attached gingiva. Angle Orthod. 2015; 85(6): 905-910. DOI: https://doi.org/10.2319/092714.695.1
Chang CH, Lin JS, Roberts WE. Failure rates for stainless steel versus titanium alloy infrazygomatic crest bone screws: A single-center, randomized double-blind clinical trial. Angle Orthod. 2019; 89(1): 40-46. DOI: https://doi.org/10.2319/012518-70.1
Viwattanatipa N, Thanakitcharu S, Uttraravichien A, Pitiphat W. Survival analyses of surgical miniscrews as orthodontic anchorage. Am J Orthod Dentofacial Orthop. 2009; 136(1): 29-36. DOI: https://doi.org/10.1016/j.ajodo.2007.06.018
Uesugi S, Kokai S, Kanno Z, Ono T. Prognosis of primary and secondary insertions of orthodontic miniscrews: what we have learned from 500 implants. Am J Orthod Dentofacial Orthop. 2017; 152(2): 224-231. DOI: https://doi.org/10.1016/j.ajodo.2016.12.021
Wilmes B, Su Y-Y, Drescher D. Insertion angle impact on primary stability of orthodontic mini-implants. Angle Orthod. 2008; 78(6): 1065-1070. DOI: https://doi.org/10.2319/100707-484.1
Reynders RM, Ronchi L, Ladu L, Van Etten-Jamaludin F, Bipat S. Insertion torque and orthodontic mini-implants: a systematic review of the artificial bone literature. J Engineer Med. 2013; 227(11): 1181-1202. DOI: https://doi.org/10.1177/0954411913495986
Motoyoshi M, Hirabayashi M, Uemura M, Shimizu N. Recommended placement torque when tightening an orthodontic mini-implant. Clin Oral Implants Res. 2006; 17: 109-114. DOI: https://doi.org/10.1111/j.1600-0501.2005.01211.x
Reynders RM, Ronchi L, Ladu L, van Etten-Jamaludin F, Bipat S. Insertion torque and success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofacial Orthop. 2012; 142: 596-614. DOI: https://doi.org/10.1016/j.ajodo.2012.06.013
Reynders RM, Ladu L, Ronchi L, et al. Insertion torque recordings for the diagnosis of contact between orthodontic mini-implants and dental roots: protocol for a systematic review. Syst Rev. 2016; 5: 50-68. DOI: https://doi.org/10.1186/s13643-016-0227-3
Marquezan M, Mattos CT, Sant'Anna EF, De Souza MMG, Maia LC. Does cortical thickness influence the primary stability of miniscrews? A systematic review and meta-analysis. Angle Orthod. 2014; 84(6): 1093-1103. DOI: https://doi.org/10.2319/093013-716.1
Lee H-S, Choi H-M, Choi D-S, Jang I, Cha B-K. Bone thickness of the infrazygomatic crest area in skeletal Class III growing patients: A computed tomographic study. Imag Sci Dent. 2013; 43: 261-266. DOI: https://doi.org/10.5624/isd.2013.43.4.261
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